scholarly journals Bilateral Sander IV calcaneus fractures: Primary fusion or fixation?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0006
Author(s):  
Rajiv Shah
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Standard Of Care ◽  
Calcaneus Fracture ◽  
Subtalar Fusion ◽  
Fall From Height ◽  
Long Term Follow Up ◽  
Calcaneus Fractures

Category: Trauma Introduction/Purpose: Primary subtalar fusion for Sander IV calcaneus fractures was considered to be the standard of care till recent past. Presently debate is on whether to manage Sander IV calcaneus fracture cases with primary subtalar fusion or with open reduction and internal fixation. Bilateral Sander IV calcaneus fractures are seen in cases with fall from height. No study has ever been conducted till date to compare the results of primary fusion of a Sander IV calcaneus fracture on one side and open reduction and internal fixation on another side in cases with bilateral Sander IV calcaneus fractures. We present a study comparing the results of primary fusion versus open reduction and internal fixation for bilateral sander IV calcaneus fracture cases. Methods: Twelve cases with bilateral closed Sander IV calcaneus fractures where included in the present study. Cases were operated between four to six weeks by a single surgeon after the appearance of wrinkles. All right sided fractures underwent open reduction and internal fixation with proximal tibia grafting. While all left-sided fractures underwent subtalar fusion with the use of ipsilateral anterior iliac crest grafts. Cases were followed up for 24 months. Results: Though operative time was more in the fusion group wound problems were equal in both the groups. Four months of average time to union was the same in both the groups and so was time to return to work. At two years, the AOFAS score was slightly better in the fusion group but it was not statistically significant. Conclusion: Primary subtalar fusion is with almost similar results as those with open reduction and internal fixation in bilateral Sander IV at 24 months. Long term follow up with more number of cases is required to prove the benefit of one over other.

Tibial Spine Fractures: A Long-term Follow-up Study of Open Reduction and Internal Fixation

2009 ◽  
Vol 23 (3) ◽  
pp. 203-207 ◽  
Author(s):  
M V Rademakers ◽  
G M M J Kerkhoffs ◽  
J Kager ◽  
J C Goslings ◽  
R K Marti ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Spine Fractures ◽  
Tibial Spine ◽  
Follow Up Study ◽  
Long Term Follow Up

Acetabular Fractures: Long-Term Follow-Up of Open Reduction and Internal Fixation

1994 ◽  
Vol 8 (5) ◽  
pp. 397-403 ◽  
Author(s):  
Rick Wright ◽  
Kim Barrett ◽  
Michael J. Christie ◽  
Kenneth D. Johnson
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Acetabular Fractures ◽  
Long Term Follow Up

Bilateral Scaphocapitate Fracture Syndrome: A Case Report with Long-Term Follow up

2019 ◽  
Vol 24 (02) ◽  
pp. 243-246
Author(s):  
Ahmadreza Afshar ◽  
Ali Tabrizi
Keyword(s):  
Bone Fracture ◽  
Open Reduction ◽  
Functional Results ◽  
Fracture Dislocation ◽  
Carpal Bone ◽  
Orthopedic Surgeons ◽  
Long Term Follow Up ◽  
Scaphocapitate Fracture Syndrome

Carpal bone fracture-dislocation is an uncommon wrist injury. Regarding limited prevalence of such injury, most of orthopedic surgeons have low experience in treatment and handling of these fractures and dislocations. A 25-year-old male worker with an uncommon carpal bone fracture-dislocation, namely bilateral scaphocapitate fracture syndrome, was described. Volar and dorsal approaches were used for reduction and fixation; complete stabilization was achieved after open reduction and fixation using Herbert screws into scaphoid and capitate. A 5-year follow-up showed satisfactory functional and radiographic results. In the case of scaphocapitate fracture syndrome open reduction and internal fixation by compression screws (rather than inserting multiple pins) leads to complete union in scaphoid and capitate. Restoration of normal anatomy in carpus bones can result in long-term satisfactory functional results while preventing possible complications.

scholarly journals Penetrance of hypertrophic cardiomyopathy and outcome in sarcomeric mutation carriers

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Lorenzini ◽  
G Norrish ◽  
E Field ◽  
J.P Ochoa ◽  
M Cicerchia ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Gene Mutations ◽  
Standard Of Care ◽  
Current Standard ◽  
Mutation Carriers ◽  
Disease Penetrance ◽  
Long Term Follow Up ◽  
Few Data

Abstract Background Predictive genetic screening of the first degree relatives of patients with hypertrophic cardiomyopathy (HCM) caused by sarcomere protein (SP) gene mutations is current standard of care, but there are few data on long-term outcomes in mutation carriers without HCM. Purpose To establish the role of sex and genotype in HCM penetrance as well as the rate of major adverse clinical events in SP mutation carriers and following the diagnosis of HCM. Methods Retrospective analysis of consecutive adult and paediatric SP mutation carriers identified during family screening and who did not fulfill diagnostic criteria for HCM at first evaluation. Results 321 individuals from 170 families [median age first evaluation 15.2 years (IQR 7.3–32.6); 153 (47.7%) males] were evaluated. Causal SP genes were: MYBPC3 (n=133 (41.4%)), MYH7 (n=77 (24.0%)), TNNI3 (n=51 (15.9%)), TNNT2 (n=40 (12.5%)), TPM1 (n=9 (2.8%)), MYL2 (n=6 (1.9%)), and ACTC1 (n=1 (0.3%)); 4 (1.3%) carried multiple mutations. After a median follow up of 7.4 years (IQR 2.5–12.7), 89 (27.7%) patients developed HCM. Disease penetrance at the age of 50 years was 47% (95% CI 38%-56%). One hundred and fifty three (47.7%) individuals underwent cardiac magnetic resonance (CMR) imaging; among those diagnosed with HCM, 22/89 (24.7%) fulfilled criteria on CMR but not echocardiography. In a multivariable model adjusted for genotype, follow up duration and evaluation with CMR, independent predictors of HCM development were male sex (HR 3.11; CI 1.82–5.32) and abnormal ECG (HR 7.87; CI 4.43–13.97). Patients with MYH7 and multiple mutations were more likely to develop HCM than those with MYBPC3 mutations (HR 2.03; CI 1.04–3.96 and HR 10.13; CI 1.40–72.92, respectively). Disease penetrance was lowest in carriers of TNNI3 mutations (HR 0.13; CI 0.03–0.48). There were no major adverse events in individuals without HCM. Following the diagnosis of HCM, the combined rate of all-cause death, appropriate defibrillator shock or resuscitated cardiac arrest was 1.1%/year [median follow up 4.0 years (IQR 2.1–8.9)]. Conclusions Approximately 50% of SP mutation carriers develop HCM by the age of 50 and become prone to disease complications during long-term follow-up. Sex, MYH7 mutations and the presence of an abnormal ECG are associated with a higher risk of disease development. CMR should be employed systematically in long-term screening. HCM penetrance by sex Funding Acknowledgement Type of funding source: None

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